肾癌骨转移-菲律宾 Kidney cancer with bone metastasis-Philippines

　　一年前在菲律宾马尼拉一个会议上，突然一个50多岁女士来到广州复大肿瘤医院徐克成院长面前，徐院长对她的面孔很熟，但一下子想不起她是什么病患者。徐院长想起来了，她是一位转移性肾癌患者，叫Rus。5年前做过手术切除。3年前，即2008年，来到广州复大肿瘤医院，已有骨转移。对于这种进展性肾癌，化疗和放疗无效，患者5年生存率从0%到13%。徐院长对她实施了联合免疫（CIC）治疗。看了她最近在菲律宾检查的CT片，基本上看不到病变了。她送给徐院长两个啤酒瓶，上面是绘制的花朵，说这是她亲手绘的，按照她家族的风俗，这些“瓶上画”代表了最尊敬人的感激。她怕徐院长不肯收下，说她是穷人，不能送贵重物件给他，也不敢送值钱东西给他，因为她知道复大医院拒收礼品的规矩，但这是不值钱的东西，但代表了她的心。徐院长接受了，虽然不完全理解这种画的含义，但他带回了这两个啤酒瓶，把它放在办公桌后书橱里，天天能看到。

　　One year ago， at a seminar in Manila， Philippines， a fifty-year-old lady suddenly came to Prof. Xu Kecheng， her face was familiar， but Prof. Xu could not recall which kind of cancer she had(Figure 9). She said， “Professor Xu， you are my great benefactor， do you think that I am still sick？” I recognized that she was a patient with metastatic renal carcinoma， her name was Rus. Five years ago she had surgery. Three years ago， the patient came to our hospital with bone metastasis. For this kind of progressive renal cancer， chemotherapy and radiotherapy do not work at all. There are ten reports showing that patients with a 5-year survival rate vary from 0-13%. Prof. Xu treated her with Combined Immunotherapy for Cancer (CIC)， which she unexpectedly greatly benefited from. Prof. Xu read her latest CT films done in the Philippines and no lesions could be seen. She gave Prof. Xu  two beer bottles with flowers that she herself had painted on as gifts. According to her family's custom， these flowers on beer bottle represent their cordial respects and gratitude. She was afraid Prof. Xu would not accept them， saying that she was too poor to send him valuables， she also did not dare send him valuables as she knew there is a rule in our hospital that all staffs are not allowed to accept gifts from patients. These were not valuables， but a token of her regards， so Prof. Xu accepted. Although Prof. Xu cannot fully understand the true meaning of the painting， he brought back these two beer bottles and put them on the bookcase in his office where he can see them everyday.

　　2011年11月19日，徐克成院长在马尼拉受到菲律宾副总统比奈的约见。Rus听说副总统要见徐院长，大早就来到徐院长住的酒店，跟着进了副总统府。比奈副总统听了徐院长介绍后，很激动，高兴地与Rus姐妹照相。

　　On November 19， 2011， the vice president Mr. Binay made an appointment with Prof. Xu in Manila. Mrs. Rus heard that Mr. Binay wanted to meet Prof. Xu， she came to the hotel that he stayed in early that morning， following Prof. Xu to go to the Vice Presidential Palace. Mr. Binay was very excited after listening to Prof. Xu’s presentation and had his photo taken with Mrs. Rus and her sister.

　　几年过去了，Rus依然健康地生存。徐院长每次到菲律宾，她总全程陪同，而且发表讲话，介绍她起死回生的经历。

　　Several years have passed， Rus is still alive and healthy. Every time Professor Xu goes to the Philippines， she always accompanies him， and shares her anti-cancer experience with those cancer patients who still live in great misery.　

　　菲律宾副总统比奈（中）接见Rus女士（左）和她的妹妹

　　Vice President of the Philippines Binay received Ms. Rus(Left) and her younger sister　

　　Rus 成为复大志愿者，正在讲述癌症康复

　　Rus is sharing her cancer rehabilitation experience as a volunteer of Fuda

　　Rus

　　肾癌骨转移 Kidney cancer with bone metastases

　　女性，58岁。肾癌，肾切除后复发骨转移。给予联合免疫治疗，转移灶消失，无病生存已6年。

　　Female， 58 years old， kidney cancer， nephrectomy with recurrent bone metastases.  After she received combined immunotherapy， the metastatic lesion disappeared. She has cancer-free survived for 6 years.

　　Rus治疗成功经验  Treatment Experience

　　转移性肾癌，尤其已进行过手术和化放疗者，预后很差，中位生存期不超过一年。但该患者无病生存已是第6年。究其原因，与正确施行免疫治疗有关。

　　Those patients with metastatic kidney cancer who have undergone surgery， chemotherapy and radiotherapy have poor prognosis and their median survival period is less than one year. However， this patient has disease-free survived for 6 years， for which is closely related to immunotherapy.

　　癌细胞具有异质性，就是说癌症基因表达多种多样，在分化过程中又十分不稳定，换句话说，今天的癌细胞不等于明天的癌细胞。免疫疗法抗击癌细胞，必须‘千军万马’、‘随机应变’，不能仅用一种免疫方法，要用多种，要随着癌细胞的变化采用不同的免疫措施。

　　Cancer cell is heterogeneous， which means cancer gene expression varies and it is very unstable during the differentiation. In other words， cancer cells change day by day. Immunotherapy shall be powerful and adaptable to fight cancer. The immunological measures used shall vary with cancer cells.

　　基于上述认识，复大肿瘤医院把各种免疫促进的方法组合起来，形成联合免疫疗法，还有非特异性免疫刺激疗法。这就好比打仗时，必须有陆军、海军、空军，甚至警察（免疫细胞和细胞因子）、情报人员（DC细胞），不仅要“扩军”，增加它们的数目，还要采取措施（非特异性疗法），“刺激”它们的积极性，让他们敢于“冲锋陷阵”。当然，在某个病人，用哪一种或几种免疫疗法，需要预先做一些特殊检查，按照具体病情作出决策，即个体化。

　　Based on the above understanding， Fuda Cancer Hospital combine a variety of immunological measures， which is so-called combined immunotherapy (CIC)， including CIK， DC， T cell transfusion therapy， cytokines injection and non-specific immunostimulating therapy. This would be like fighting a battle， the Army， Navy， Air Force， and even the police (immune cells and cytokines)， intelligence agent (DC cells) are indispensable. For immune cells， it shall not only increase their number， but also take measures (non-specific therapy) to stimulate their enthusiasm， so that they dare to make a frontal attack on cancer cells. Of course， in some patients， before they receive one or more immunological measures， some special pre-tests shall be carried out to understand individual differences， on which personalized treatment will be made.

　　按照Rus的具体情况，复大专家给她CIC治疗，并特别给她长期的非特异性免疫促进治疗，重在调动患者天生的抗癌能力，从而使得癌细胞受到抑制，甚至被消灭（实际上是凋亡），让患者长期生存。这是巨大的成功，可称为奇迹！

　　According to Rus’s specific condition， she was recommended to undergo CIC long-term non-specific immune therapy， focusing on mobilizing the initiative of innate anti-cancer ability to inhibit or even eliminate cancer cells (apoptosis)， so she manage to obtain long-term survival. It is a great success， which can be called a miracle！